Sjögren-like syndrome in kappa chain deficiency.
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Biomedical subjects
Publications and source records attributed to R Rosso.
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This retrospective study analyzes overall survival and relapse-free survival after mastectomy and survival after recurrence of 302 patients with metastatic breast cancer. In the whole group the median survival after mastectomy is 99 months: 5-year survival rate is 68.4% and 10-year survival rate is 38.5%. The median survival from relapse was 36 months: 5-year and 10-year survival rates were respectively 26.8 and 18.9%. Various subsets of patients divided according to several prognostic factors have been analyzed.
After primary surgery, 125 patients with epithelial ovarian cancer (International Federation of Gynaecology and Obstetrics [FIGO] 1c + IIb + IIc = 22 patients, FIGO III = 82 patients, FIGO IV = 21 patients) were randomly allocated to receive PC (cisplatin 50 mg/m2 + cyclophosphamide 600 mg/m2 on day 1 every 28 days) (corrected) or PAC (PC + doxorubicin 45 mg/m2). After six cycles, patients clinically disease-free or with resectable residual disease were submitted to second-look surgery. After restaging, patients in surgical complete response (CR) stopped treatment while those responding partially (PR) received six more courses; patients whose disease progressed were excluded from the study. Among patients with measurable disease, the following clinical response rates were observed: PC = 20% CR, 34.3% PR, 14.3% stable disease, and 31.4% progression; PAC = 40.6% CR, 15.6% PR, 12.5% stable disease, and 31.3% progression. In the 75 patients submitted to second look, the results have been the following: PC = 39.5% CR, 36.8% PR, 7.9% stable disease, and 15.8% progression; PAC = 62.2% CR, 18.9% PR, 10.8% stable disease, and 8.1% progression. The difference in surgical complete response in favor of the PAC regimen is significant (P less than .05). Median survival and progression-free survival were 800 and 400 days, respectively, for PAC arm; median survival and progression-free survival were 680 and 380 days, respectively, for PC. These differences are not significant. Probability of survival was affected by FIGO stage, amount of residual disease, histology, performance status, and response at second look, while no influence was observed according to grade of tumor differentiation and age. Our results demonstrate the usefulness of doxorubicin in terms of surgical CR.
Twenty-nine patients with metastatic breast cancer were treated orally with idarubicin (15 mg/m2 X 3 days every 3-4 weeks). Objective response was seen in 31% of all patients. Toxicity was acceptable. There should be further clinical trials of new anthracycline antibiotic.
A phase II study with mitoxantrone has been carried out in 30 metastatic breast cancer patients. Of 26 evaluable patients 7 (26.9%) experienced a partial response; 7 (26.9%) patients had stable disease and 12 (46.1%) had progression. Major toxicity observed was: nausea and vomiting in 52% of patients, moderate hair loss in 53% of patients and leukopenia in 53%.
A case of dilated cardiomyopathy arose after a spontaneous abortion at the second month of pregnancy is reported. Whereas clinical, hemodynamic and gross features pointed to a diagnosis of right ventricular cardiomyopathy, histologic findings of inflammatory infiltration, myocyte degeneration and interstitial fibrosis of the atrial and ventricular walls allowed to a correct diagnosis of chronic myocarditis.
Thirty-six patients with locally advanced breast cancer received diethylstilbestrol (1 mg/die) for 3 days followed by FAC (5 Fu 600 mg/m2, adriamycin 50 mg/m2, cytoxan 600 mg/m2) on day 4, q. 21 days. After three cycles, responsive patients were submitted to surgery. Tumor kinetic parameters were evaluated by TLI and PDP-LI in 22 patients on serial tumor biopsies at diagnosis (TO), after DES (T1), 24 hrs after the first FAC (T2) and at the time of radical surgery (T3). An estrogenic recruitment was evident by TLI in 9/22 tumors and by PDP-LI in 16/22 patients. Our results demonstrate that diethylstilbestrol can induce a kinetic recruitment of breast cancer cells independently from their ER content and that chemotherapy is able to stop cell proliferation.
Between July '84 and July '85, 20 patients with very advanced or relapsing carcinomas of the upper aerodigestive tract were treated with polychemotherapy (cisplatin 20 mg/m2 days 1 to 5, and 5-fluorouracil 200 mg/m2 days 1 to 5, q. 3 weeks), alternated with radiation (3 split courses, 20 Gy each). Toxicity was moderate and in particular, mucositis and other relevant side effects including leukopenia, thrombocytopenia and nausea, were rare. Antitumoral activity consisted of nine complete responses and six partial responses (75% objective responses). Our conclusions are that cisplatin and 5-FU can be alternated with radiation with acceptable toxicity. The treatment has shown interesting antitumoral activity. Its role in cancer management must be investigated with controlled clinical trials.
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A randomized trial was performed comparing the antiemetic efficacy of methylprednisolone (MPN) and metoclopramide (MCP) in 60 breast cancer patients eligible for outpatient adjuvant chemotherapy with cyclophosphamide, methotrexate, and 5-FU (CMF). At the time of their first chemotherapy course patients were randomized to receive either MPN 375 mg or MCP 1 mg/kg both administered in 3 equal doses, IV just prior to chemotherapy and then IM 6 and 12 hours after treatment. Patients receiving MPN experienced significantly less nausea (p less than 0.0005) and vomiting (p less than 0.0005) and antiemetic protection was maintained in patients receiving multiple chemotherapy courses. Complete protection (0 emesis) was observed in 58% of patients receiving MPN as compared with 20% of patients treated with MCP (p less than 0.005). The most frequent side effects were facial flush in 38% of patients and somnolence in 15% of patients receiving MPN and MCP, respectively. Complete protection from CMF-induced gastrointestinal side effects was observed in two-thirds of our patients receiving antiemetic MPN treatment. In these patients administration of the maximum cumulative CMF dose was possible without impairing their quality of life. MPN, at the dose and schedule reported, is an affective antiemetic drug suitable for use in breast cancer outpatients receiving adjuvant CMF therapy.
Between August 1979 and August 1984, 47 consecutive patients with recurrent squamous cell carcinoma of the head and neck entered one of three consecutive second-line treatments. Response rates with each treatment were very different (70% vs 5.9% vs 75%), but there was no statistical difference in actuarial survival (survival: 30% vs 29% vs 20%, respectively, at 260 days). In light of this observation, the efficacy of the second-line therapy appears doubtful and the survival of relapsing patients seems unrelated to the response achieved.
Aminoglutethimide, a drug known to block adrenal steroidogenesis and peripheral aromatization of androgens to estrogens, has been found effective in the treatment of breast cancer. The drug has been used in our Institute to treat 71 consecutive metastatic breast cancer patients. Of 67 patients evaluable for response, 9 (13.4%) have achieved a partial response, 30 (44.7%) stable disease, and 28 (41.7%) progression of disease. Four patients were taken off the therapy because of drug-related toxicity.
Of 325 consecutive cases of non-Hodgkin's malignant lymphomas, 8 patients (2.4%) showed orbital presentation. The clinicopathologic and immunologic analysis of the eight patients revealed characteristic biologic features. Despite the apparently isolated orbital presentation, all cases had subclinical systemic disease. Seven of the eight cases exhibited lymphoplasmacytic/cytoid features, with concurrent type II cryoglobulinemia in five of them. In addition, during their clinical course, five patients showed single or multiple subcutaneous nodules with the same histologic and immunologic pattern as the orbital tumor. This study demonstrates that most orbital lymphomas share particular clinicopathologic and immunologic features, suggesting an origin from a B-cell subset with preferential homing to orbital tissues and subcutis.
Mitomycin plus vindesine have been utilized as salvage therapy in metastatic breast cancer patients refractory to first line chemotherapy. No response was observed in 15 consecutively evaluable patients; according to the Gehan test a lack of effectiveness of this regimen is suggested at least in heavily pretreated patients.
Both chemotherapeutic agents and hormones are effective in breast cancer treatment. Their mechanism of action seems to be conflicting: while cytotoxic drugs are active on cycling cells, hormones prolong the G0 phase. Therefore, the concurrent use of hormones and chemotherapy could decrease their expected clinical activity. On the contrary, a review of the literature suggests that there could be some synergistic action with combined therapy. The problem is therefore to assess the efficacy of simultaneous vs sequential administration of hormones and chemotherapy. In advanced disease the general conclusion could be that simultaneous administration of combined therapy: increases, although the difference is not statistically significant, the response rate both in pre and postmenopausal patients; and the most important end point, total survival, is not statistically improved by simultaneous vs sequential administration. In addition, in the adjuvant setting combined treatment appears superior to chemotherapy only in postmenopausal, receptor-positive patients. No definite conclusion is today available in premenopause.
UNLABELLED: Eighty-one patients with advanced measurable breast cancer were randomized to receive only chemotherapy (Group C) or the same chemotherapy + tamoxifen (Group CH). The chemotherapeutic regimen was based on the cyclic administration of two noncross-resistant cytotoxic combinations: CMFV (cyclophosphamide 300 mg/m2 i.v., days 1 and 5; methotrexate, 20 mg/m2 i.v., days 1 and 4; 5-fluorouracil 325 mg/m2 i.v., days 1-5; vincristine 0.75 mg/m2 i.v., days 2 and 5) and AC (adriamycin 40 mg/m2 i.v., day 1; cyclophosphamide 200 mg/m2 i.v., days 3-5) every 4-5 weeks. Tamoxifen (10 mg) was given twice daily continuously. The treatment results were as follows in Groups C and CH, respectively: PD 19.4 and 6.3%, SD 38.9 and 18.7%, PR 27.8 and 56.2% and CR 13.9 and 18.7%. The difference in response (CR + PR) rate observed between the two treatment groups was highly significant (P less than 0.025). Median time to progression was 10.6 months in Group C and 17.2 months in Group CH (NS). Median duration of survival was 20 and 34 months, respectively (NS). IN CONCLUSION: the addition of tamoxifen to chemotherapy significantly improved the results in terms of response rate and duration of responses. A significant benefit to short-term survival was also evident.